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Background Evidence is lacking about any additional benefits of introducing remdesivir on top of dexamethasone, and the optimal timing of initiation. Methods In a territory-wide cohort of 10 445 coronavirus disease 2019 (COVID-19) patients from Hong Kong who were hospitalized between 21 January 2020 and 31 January 2021, 1544 had received dexamethasone during hospitalization. The exposure group consisted of patients who had initiated remdesivir prior to dexamethasone (n = 93) or co-initiated the 2 drugs simultaneously (n = 373), whereas the nonexposure group included patients who were given remdesivir after dexamethasone (n = 149) or those without remdesivir use (n = 929). Multiple imputation and inverse probability of treatment weighting for propensity score were applied and hazard ratios (HRs) of event outcomes were estimated using Cox regression models. Results Time to clinical improvement (HR = 1.23; 95% CI, 1.02–1.49; P = .032) and positive IgG antibody (HR = 1.22; 95% CI, 1.02–1.46; P = .029) were significantly shorter in the exposure group than that of nonexposure. The exposure group had a shorter hospital length of stay by 2.65 days among survivors, lower WHO clinical progression scale scores from 5 days of follow-up onwards, and lower risks of in-hospital death (HR = .59; 95% CI, .36–.98; P = .042) and composite outcomes; and without experiencing an increased risk of acute respiratory distress syndrome. Differences in the cumulative direct medical costs between groups were no longer significant from 17 days of follow-up onwards. Conclusions Initiation of remdesivir prior to or simultaneously with dexamethasone was associated with significantly shorter time to clinical improvement and positive IgG antibody, lower risk of in-hospital death, in addition to shorter length of hospital stay in patients with moderate COVID-19.

Background and objectives Type 2 diabetes mellitus (T2DM) patients with Coronavirus Disease 2019 (COVID-19) have poorer prognosis. Inconclusive evidence suggested dipeptidyl peptidase-4 inhibitors (DPP4i) might reduce inflammation and prevent Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) entry hence further evaluation on DPP4i is needed. Methods 1214 Patients with T2DM were admitted with COVID-19 between 21st January 2020 and 31st January 2021 in Hong Kong. Exposure was DPP4i use within the 90 days prior to admission for COVID-19. Assessed outcomes included clinical deterioration, clinical improvement, low viral load, positive Immunoglobulin G (IgG) antibody, hyperinflammatory syndrome, proportion of IgG antibody, clinical status and length of hospitalization. Multivariable logistic and linear regression models were performed to estimate odds ratios (OR) and their 95% confidence intervals (CI) of event outcomes and continuous outcomes, respectively. Results DPP4i users (N=107) was associated with lower odds of clinical deterioration (OR=0.71, 95%CI 0.54 to 0.93, P = 0.013), hyperinflammatory syndrome (OR=0.56, 95%CI 0.45 to 0.69, P < 0.001), invasive mechanical ventilation (OR=0.30, 95%CI 0.21 to 0.42, P < 0.001), reduced length of hospitalization (-4.82 days, 95%CI –6.80 to –2.84, P < 0.001), proportion of positive IgG antibody on day-3 (13% vs 8%, p=0.007) and day-7 (41% vs 26%, P < 0.001), despite lack of association between DPP4i use and in-hospital mortality. Conclusion DPP4i use was associated with reduced odds of clinical deterioration and hyperinflammatory syndrome. Prospective studies are warranted to elucidate the role of DPP4i in T2DM and COVID-19.

Routine gas flaring in oil producing nations is one of the top environmental challenges that must be addressed for improving sustainability measures across the petroleum industry. How can we accurately estimate potential reductions in gas flaring? This paper describes an extended inverse data envelopment analysis (DEA) model for estimating potential reductions in global gas flaring. The potential reductions are needed for the conversion of flared gas to electricity via the gas-to-wire (GTW) process. In this connection, the optimal sizing of the GTW process depends on the potential reductions and the annual gas usage requirement of turbines. The proposed methodology in this paper was applied to the situation in member nations of the organization of the petroleum exporting countries (OPEC). Initial results revealed that six nations were inefficient oil producers, indicating that there is ample room for reduction in gas flaring. The main results showed that the maximum potential reductions in gas flaring for Algeria, Indonesia, Iraq, Nigeria, UAE, and Venezuela are 83.11%, 78.35%, 91.62%, 91.24%, 55.76% and 95.06%, respectively. For all six producers, the computed number of turbine units required for setting up the GTW process are 8, 5, 25, 38, 1 and 25, respectively. Further, Nigeria and Venezuela are currently experiencing an energy supply crisis, and, as evident in our results, both these oil producing nations can generate power using a maximum of 38 and 25 turbine units, respectively. We recommend both producers should invest in the GTW process and in a more highly skilled labor force, on par with those of the benchmarks identified by our proposed model.

Introduction/Background Androgen ablation therapy (ADP) in prostate cancer patients may cause complications such as cardiovascular disease, metabolic syndrome and fatigue. The study aimed to evaluate the effect of regular rehabilitation exercise using smart after care in improvement of exercise capacity in prostate cancer patients undergoing ADP. Material and method The prostate cancer patients under ADT with age of or over 40 years were recruited and randomly allocated. The exercise group was provided with a smart aftercare program application and wearable device, providing general health information, nutritional and medication care and rehabilitation program which was adjusted in level according to the test results at 6 weeks follow up. The patients visited at time of enrollment, 6 weeks and 12 weeks and their physical performance status (2 minutes’ walk test, 30-second chair stand test, grip strength test, short physical performance battery) was tested. The quality of life and satisfaction was evaluated with questionnaires (EORTC QLQ C30, PR 25) and body composition was additionally measured. Results After 12 weeks, the exercise group showed significant improvement in social functioning (P = 0.016) as well as in appetite loss (P = 0.048) ( Table 1 ). Both groups showed significant improvement in urinary symptom, whereas the exercise group additionally showed significant improvement in sexual functioning (P = 0.032). In the aspect of physical performance, both groups showed significant improvement in 30s chair stand test and 2 minutes’ walk test after 12 weeks of smart aftercare program, whereas the exercise group had additional significant improvement in right hand grip strength (P = 0.047) and reduction in body fat percentage (P = 0.003)( Table 2 ). Conclusion The smart aftercare program is a safe, highly satisfied method that also helps increase compliance among participants. Therefore it is an effective method in prostate cancer patients under hormone therapy in improving exercise capacity and general health related quality of life.

Aflatoxins are very toxic secondary metabolites produced by fungi. Fermented foods are considered major sources of aflatoxin contamination. Consumption of fermented food contaminated with high amounts of aflatoxins often results in serious health complications. Chronic exposure to aflatoxins from fermented foods affects 4.5 billion persons living in developing countries. Most traditional fermented foods worldwide are produced at varying scales, and food safety risk management and risk assessment are conducted primarily by governments. From a food processing point of view, major risk factors include contaminated raw materials, lack of pasteurization, and poorly controlled natural fermentation. Prior risk assessment has established safety regulations and standards for traditional fermented foods. This chapter presents an overview of major aflatoxins as well as current methods used to control aflatoxin contamination in fermented foods.

In today's competitive environment, business organizations are forced to maintain their competitive advantage by their ability to cut costs, increase revenue and uncover hidden issues. In order to enhance the visibility and transparency of value added information in a supply chain network, a process mining system is proposed for discovering a set of fuzzy association rules based on the daily captured logistics operation data, within the network. The proposed methodology provides all levels of employees with the ability to enhance their knowledge and understanding of the current business environment. Once interesting association rules have been extracted, organizations can identify the root-causes of quality problems in a supply chain and improve performance by fine-tuning the configuration of process parameters in specified processes. The application of the proposed methodology in a case company has also been studied. The prototype system has been developed and evaluated after performing a spatial analysis. The results obtained indicate that the system is capable of extracting high-quality and actionable information in the case company.

The temperature of root zone is known as an important factor for the growth of crops and reduction of energy in greenhouse. The purpose of this study was to design the solar energy supply system to keep the optimum condition of root zone by soil warming. As a result of this study, soil warming compared with no warming changed on a large scale temperature rise effect by depth of soil. The greenhouse`s inner temperature have an effect on the temperature of surface up to 15 cm, rised to about 1 hour after warming. In case of the temperature fluctuation, soil temperature was about up to 1525 cm and it was at greater depths. This results showed that the position of root zone was very different after 3 weeks of growth.

In the semiconductor industry, dynamic changes in demand force companies to change the product mix frequently and periodically. Assigning tight but attainable due dates is a great challenge under the circumstances that the product mix changes periodically. In this paper, we consider the due-date assignment problem for wafer fabrication and present a due-date assignment model to set manufacturing due dates satisfying the target on-time-delivery rate. The contamination model is applied to tackle the effect of that product mix varies periodically. We demonstrate the effectiveness and accuracy of the proposed model by solving a real-world example taken from a wafer fabrication shop floor in an IC manufacturing factory

A new approach to process optimal design in non-isothermal, non-steady metal forming is presented. In this approach, an optimal design problem is formulated on the basis of an integrated thermo-mechanical finite element process model so as to treat diverse process parameters, either thermal or mechanical, as the design variables to be optimized, and a derivative based approach is adopted for conducting optimization. Described in detail are the integrated process model, a formulation for process optimal design, and the schemes for the evaluation of design sensitivity, in particular, a scheme for reflecting the effect of remeshing on design sensitivity. The validity of the schemes for the evaluation of design sensitivity is examined by performing a numerical test. Also examined is the integrated process model regarding its capability of predicting defect formation, through comparison with experimental observations. Then, the proposed optimal design technique is applied to process optimization in non-isothermal backward extrusion of a titanium alloy, with emphasis on preventing defect formation.

Otoacoustic emissions (OAEs) have been widely used as an objective and noninvasive method of assessing outer hair cell function of the cochlea for infants. This paper is aimed at investigating the infant hearing screening service in Hong Kong using distraction test and distortion product otoacoustic emissions (DPOAEs). In Study 1, the DPOAE results were obtained using two criteria: Criterion I was (DP response - noise floor) > 2 standard deviations above noise floor; and Criterion II was (DP response - noise floor) > 6 dB. The results were compared with pure tone audiograms for 43 young children who were able to give reliable responses in play audiometry. Criterion I was found to be superior to Criterion II in view of its higher specificity (86.5%). Hence Criterion I was used in a subsequent study, Study 2. In that second study, 144 (73%) out of 196 infants who failed the distraction test passed the DPOAE hearing screening. Most infants who failed the distraction test were under 6 months old (122...

The internal grooved (undercut) features of plastic injection moulded parts are formed by collapsible cores. While collapsible cores have been designed for pipe sizes smaller than 90 mm in diameter, those for larger pipes are custom designed. The objective of this research was to fully automate the design procedure which, for uPVC pipe fittings is laborious and error-prone at present. This paper discusses the design of the four key geometrical features of a two-stage, lever-actuated collapsible core, namely, the number of segments, the path of the retracting segments during demoulding, the minimum angle of taper of the grooved undercut to permit the segments to retract during de-moulding and the prevention of interference between moving components. After these key geometrical features are established, it is then possible to fully automate the design of two-stage, lever-actuated collapsible cores in a CAD system.

A new approach to process optimal design in non-steady forming of porous metals is presented. In this approach, the optimal design problem involving diverse objective functions and design variables is formulated on the basis of the finite element process model, and a derivative-based approach is adopted as the solution technique. The process model, the formulation for process optimal design, the schemes for the evaluation of the design sensitivity, and an iterative procedure for optimization are described in detail. The validity of the schemes for the evaluation of the design sensitivity is examined by performing a series of numerical tests. The capability of the proposed approach is demonstrated through application to a selected design problem.

Surface morphology studies of GaN and AlGaN grown by metalorganic chemical vapor deposition (MOCVD) have been carried out using atomic force microscopy. The open core dislocation and steps connecting two threading dislocations of opposite direction are commonly observed in undoped and doped GaN. Structural studies on AlGaN epitaxial layers grown on undoped GaN revealed the formation of open-core dislocation with width upto 300 nm. The nanopipes originate from the threading dislocation formed due to large lattice mismatch between sapphire and GaN. The mismatch also leads to high strain in the epilayers resulting in cracking effect at the edges of the hexagonal V-type defect. The self organized quantum dots features on the smooth surface of AlGaN epitaxial layer exhibit the Stranski–Krastanov(SK) mode of island growth.

Statistical simulation using design of experiments has been employed for integrated circuit technology development. A software program called STADIUM was developed to implement this statistical methodology. The software has been designed to be user friendly and to guide the engineer who is not a statistics expert through the process of deriving a valid statistical answer. Inputs to the STADIUM system include integrated circuit fabrication variations and when coupled with semiconductor process and device simulators can estimate the expected variations of device parameters such as transistor gain and threshold voltage. This paper presents the detailed procedure and results of a statistical simulation of a bipolar transistor technology.

The fluctuating and competitive economy today is affecting the production industry worldwide. Under the stress of various forceful challenges, customer satisfaction and product loyalties form the necessary key for enterprises to survive or even thrive in this decade. The concept of Quality Management System (QMS) offers a chance for enterprises to win customer satisfaction by producing consistently high-quality products. With the use of Data Mining (DM) and Artificial Intelligence (AI) techniques, enterprises are able to discover previously hidden yet useful knowledge from large and related databases which assists to support the high-valued continuous quality improvement. Continuous quality improvement is of utmost importance to enterprises as it helps turn them potent to compete in today’s rivalrous global business market. In this chapter, Intelligent Quality Management System with the use of Fuzzy Association Rules is the main focus. Fuzzy Association Rule is a useful data mining technique which has received tremendous attention. Through integrating the fuzzy set concept, enterprises or users are able to decode the discovered rules and turn them into more meaningful and easily understandable knowledge, for instance, they can extract interesting and meaningful customer behavior pattern from a pile of retail data. In order to better illustrate how this technique is used to deal with the quantitative process data and relate process parameters with the quality of finished products, an example is provided as well to help explain the concept.

Aviation industry is highly dynamic and demanding in nature that time and safety are the two most important factors while one of the major sources of delay is aircraft on ground because of it complexity, a lot of machinery like vehicles are involved and lots of communication are involved. As one of the aircraft ground services providers in Hong Kong International Airport, China Aircraft Services Limited (CASL) aims to increase competitiveness by better its service provided while minimizing cost is also needed. One of the ways is to optimize the number of maintenance vehicles allocated in order to minimize chance of delay and also operating costs. In the paper, an agent-based model is proposed for support decision making in vehicle allocation. The overview of the aircrafts ground services procedures is firstly mentioned with different optimization methods suggested by researchers. Then, the agent-based approach is introduced and in the latter part of report and a multi-agent system is built and proposed which is decision supportive for CASL in optimizing the maintenance vehicles' allocation. The application provides flexibility for inputting number of different kinds of vehicles, simulation duration and aircraft arrival rate in order to simulation different scenarios which occurs in HKIA.

Inflammation is important in plaque vulnerability but the role of atheroprotective mediators in unstable plaques is not defined. The apolipoproteinA-I (apoA-I) component of HDL, and CD4+/CD25+ regulatory T cells (with their major transcription factor, Foxp3), have been implicated in the suppression of vascular inflammation. Our aim was to characterise the presence of these novel "protective" markers (apoA-I and Foxp3) in carotid plaques from symptomatic and asymptomatic subjects.Plaques from 57 patients (25 symptomatic, 32 asymptomatic) were stained immunohistochemically for macrophages (CD68), T cells (CD3), monocyte chemotactic protein-1 (MCP-1), matrix metalloproteinase-2 (MMP-2), myeloperoxidase (MPO), apoA-I and Foxp3. Twelve randomly selected plaques (6 asymptomatic, 6 symptomatic) were immunostained for interleukin-10 (IL-10) and interleukin-17 (IL-17). Staining was quantified using Image-Pro Plus software. Significantly greater areas of positive immunostaining for CD68, CD3, MCP-1, MMP-2, IL-17 and MPO were found in plaques from symptomatic patients compared with asymptomatic patients (p0.05 for all). Furthermore, significantly greater areas of positive immunostaining for apoA-I, Foxp3 and IL-10 were found in symptomatic versus asymptomatic plaques (p0.05 for all). The presence of apoA-I was correlated significantly and co-localised with CD3, CD68, MCP-1, MMP-2 and MPO immunostaining (R=0.70, 0.63, 0.52, 0.55 and 0.79, respectively; p0.01 for all). Foxp3 immunostaining also correlated significantly with CD3 (R=0.42), CD68 (R=0.47), MCP-1 (R=0.55) and MMP-2 (R=0.44) immunostaining (p0.05 for all).ApoA-I and Foxp3 are over-abundant in plaques from symptomatic subjects and co-localise with key inflammatory mediators. These data suggest ineffective/insufficient protection against atherosclerosis-mediated inflammation by these "atheroprotective" moieties.

In this paper, the classification of liver diseases using first-order statistics (FOS) is implemented for automatic preliminary diagnosis of liver diseases. Region of interest (ROI) extracted from MRI images are used as the input to characterize different tissue, namely liver cyst, fatty liver and healthy liver using first-order statistics. The results for first-order statistics are given and their potential applicability in grid computing is discussed. The measurements extracted from First-order statistic include entropy and correlation achieved obvious classification range in detecting different tissues in this work.

This paper investigates the channel broadening effect by the n-LDD (n-Lightly Doped Drain) doping on the n-channel MOSFET. The n-LDD L/sub eff/ modulation is due to charge density distribution by the gate bias and the carrier distribution 'spill out' of the source and drain into the channel. In this work, we present deep submicron silicon n-LDD experimental results with a comparison of several well-known L/sub eff/ measurement techniques. Low n-LDD implant concentration modulates L/sub eff/. As the n-LDD doping level increases, the channel length modulation effect is reduced, providing optimum device performance. Several MOSFET effective channel length, i.e., L/sub eff/, extraction methods with constant gate drive were used to observe n-LDD L/sub eff/ modulation. It is found that a constant gate drive is required to provide accurate results particularly when severe SCE or RSCE are observed. The L/sub eff/ measurements indicate that several different methods investigated provide matching results only when constant gate drive is used.

A new DC-to-DC converter is proposed that uses only switched capacitors. The energy conversion is based on controlled cyclical switching between two phases. The DC gain can be fixed by choosing an appropriate steady-state value of the duty ratio. The output voltage can be kept constant over a large range of loads. The output voltage ripple was less than 5% for most of the load range interval. By avoiding the use of magnetic elements, a small-size and lightweight converter can be built. The circuit is analyzed by using the state-space averaging method. The theoretical results have been confirmed by experimental data. >

For the first time, 512 Mb DRAMs using a Recess-Channel-Array-Transistor(RCAT) are successfully developed with 88 nm feature size, which is the smallest feature size ever reported in DRAM technology with non-planar array transistor. The RCAT with gate length of 75 nm and recessed channel depth of 150 nm exhibits drastically improved electrical characteristics such as DIBL, BV/sub DS/, junction leakage and cell contact resistance, comparing to a conventional planar array transistor of the same gate length. The most powerful effect using the RCAT in DRAMs is a great improvement of data retention time. In addition, this technology will easily extend to sub-70 nm node by simply increasing recessed channel depth and keeping the same doping concentration of the substrate.

Reliability and safety in flight is extremely necessary and that depend on the adoption of proper maintenance system. Therefore, it is essential for aircraft maintenance companies to perform the manpower scheduling efficiently. One of the objectives of this paper is to provide an Integer Programming approach to determine the optimal solutions to aircraft maintenance planning and scheduling and hence the planning and scheduling processes can become more efficient and effective. Another objective is to develop a set of computational schedules for maintenance manpower to cover all scheduled flights. In this paper, a sequential methodology consisting of 3 stages is proposed. They are initial maintenance demand schedule, the maintenance pairing and the maintenance group(s) assignment. Since scheduling would split up into different stages, different mathematical techniques have been adopted to cater for their own problem characteristics. Microsoft Excel would be used. Results from the first stage and second stage would be inputted into integer programming model using Microsoft Excel Solver to find the optimal solution. Also, Microsoft Excel VBA is used for devising a scheduling system in order to reduce the manual process and provide a user friendly interface. For the results, all can be obtained optimal solution and the computation time is reasonable and acceptable. Besides, the comparison of the peak time and non-peak time is discussed.

An improved design for a switched-capacitor pulsewidth modulated (PWM) DC-DC converter with adjustable conversion ratios is presented. The converter provides a nominal power of 40 W and nominal voltage conversion ratio of 12/5. The same structure can provide other conversion ratios, as required. Such low power supplies use relatively small, low-value capacitors, and could conceivably be realized with IC technology. >

An attempt was made to explore the possibility of using the masticatory muscle reflexes as pain indices in human subjects. It was found that the digastric reflex, so readily evoked by electrodental stimulation in experimental animals, could not be consistently elicited in man. The reflex silent period of the masseteric muscles, on the other hand, may be used as a pain index for evaluating dental analgesia, provided that analgesic interference is anticipated at points along the reflex arc.

Because of a family history of X-linked immunodeficiency, serum concentrations of immunoglobulins were measured repeatedly in term monozygotic (p = 0.9954)t twin boys, A and B, in the first five months of life. Hypo-y-globuiinemia was diagnosed and y-globulin (Connaught) subsequently was given every two to six weeks. Their last doses were given between 30 and 34 months of age; A received y-globulin once, at 33 months, but B every eight weeks. No further v-globulin was given. Chest roentgenograms since birth have failed to show a thymus in

There is a need for cast biasing in open pit mining. Although this type of blasting requires higher explosive consumption, the 30 to 40% saving on handling broken muck justifies application of this technique. Based on the HEAVE module built in SABREX, a computer blast simulation program developed by ICI, effective cast blasting for different site conditions can be designed and confirmed by means of high speed photography. Case studies given in the paper confirm the model's ability to make realistic predictions